Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Infusions, Spinal”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,297 records · Page 72Linked to original sources
PubMed1996

Lasting reduction of severe spasticity after ending chronic treatment with intrathecal baclofen.

OBJECTIVE: To investigate whether the dose of intrathecal baclofen necessary for a sufficient reduction of muscle tone and spasms changes during treatment of severe spasticity. METHODS: A group of 27 patients received intrathecal baclofen for 61 (SD 18) months. RESULTS: Spasticity remained absent or strongly reduced after stopping the intrathecal baclofen infusion in seven patients. The dose of baclofen could be reduced to 40% of that dose which was originally necessary in 10 patients. The dose remained the same or increased slightly in 10 patients. Possible reasons for the continuing reduction of spasticity after terminating long term intrathecal baclofen infusion in some patients could be: lasting morphological changes in spinal cord neurons by second messenger controlled modulation of gene expression, a toxic effect of baclofen on spinal neurons, muscular atrophy, inflammation due to the catheter, or progression of multiple sclerosis. CONCLUSIONS: A higher initial daily dose of intrathecal baclofen might lead to a faster, lasting suppression of spasticity and the development of spastic symptoms might even be prevented by pre-emptive treatment with baclofen in patients with newly acquired lesions of the spinal cord.

Adult↗
PubMed1987

Protein synthesis during hypoxia in fetal lambs.

The goal of this study was to test the hypothesis that the rate of fetal protein synthesis decreases during fetal hypoxia. Catheters were inserted into 13 sheep fetuses under maternal spinal and local fetal anesthesia. Five days after surgery, an infusion of L-[1-14C]tyrosine (0.05-0.25 muCi/min) was begun. Measurements were first made when tyrosine-specific activity reached steady state at 3 h and then again 3 h after fetal oxygen delivery was reduced by lowering the maternal inspired oxygen concentration. Fetal tyrosine uptake across the umbilical circulation was 1.34 +/- 0.20 mumol X kg-1 X min-1 during normoxia and decreased to 0.72 +/- 0.12 mumol X kg-1 X min-1 during hypoxia (P = 0.017). Tyrosine use from the plasma compartment was 1.25 +/- 0.18 mumol X kg-1 X min-1 during normoxia and decreased to 0.64 +/- 0.12 mumol X kg-1 X min-1 (P = 0.0005) during hypoxia. Fetal tyrosine use decreased during reduced oxygen delivery because the rate of tyrosine use for fetal protein synthesis decreased from 0.97 +/- 0.17 to 0.38 +/- 0.09 mumol X kg-1 X min-1 (P = 0.0004). Fetal oxygen consumption decreased by 40 mumol X kg-1 X min-1 during hypoxia. Decreased protein synthesis reduced the energy needed for protein synthesis and explained 28 mumol X kg-1 X min-1 of this reduction.

Animals↗
PubMed2004

Preventing vincristine sulfate medication errors.

PURPOSE/OBJECTIVES: To review the clinical pharmacology of vincristine sulfate, describe three types of medication errors associated with its use, and suggest strategies for vincristine sulfate medication error prevention. DATA SOURCES: Published books and journal articles, online newsletters and documents, pharmaceutical manufacturers package inserts, and personal experience. DATA SYNTHESIS: Medication errors involving vincristine sulfate include overdosage (wrong dose), name confusion (wrong drug), and incorrect administration (wrong route). CONCLUSIONS: Vincristine medication errors are preventable errors that usually result in serious patient harm and often are lethal. IMPLICATIONS FOR NURSING: Nurses need to be aware of the types of medication errors that can occur with chemotherapy agents and be familiar with clinical signs and symptoms associated with these errors. Nurses also need to promote patient safety by implementing specific strategies to prevent vincristine medication errors.

Adult↗
PubMed1985

Curability of Burkitt's lymphoma with high-dose cyclophosphamide-high-dose methotrexate therapy and intrathecal chemoprophylaxis.

Twenty-four children with Burkitt's lymphoma were treated beginning May 1976 with a regimen alternating high doses of cyclophosphamide and methotrexate in induction and consolidation; only high doses of methotrexate were used in the maintenance phase. Throughout therapy, which was planned for 54 weeks, intrathecal chemoprophylaxis using methotrexate, cytosine arabinoside, and hydrocortisone was coordinated with the high-dose methotrexate infusion therapy to provide CNS chemoprophylaxis that maintained therapeutic methotrexate spinal fluid levels (greater than 10(-6) mol/L) for approximately 60 hours. Twenty-two (92%) of the 24 children attained complete remission; two (8.3%) patients attained only partial remission, failing therapy. Two children died of infection while in complete remission; two children relapsed on therapy. Actual survival is 75%; the median follow-up time is 38+ months (range, 1 1/2+ to 84+ months). Relapses correlated with Murphy disease stage as follows: stage I--0/3, stage II--2/7, stage III--2/10, and stage IV--0/2. Serious side effects and toxicities of chemotherapy occurred in ten patients (metabolic disturbances after rapid tumor lysis, two; infectious and/or febrile episodes following cyclophosphamide therapy, three; methotrexate side effects, four; and complications of intrathecal therapy, one). Results of this therapy are similar to those of the best regimens that have been reported. Treatment has been adapted for use in Burkitt's lymphoma by the Pediatric Oncology Group; the responsiveness of other B cell lymphomas of childhood to this treatment is also being determined.

Adolescent↗
PubMed2005

Acute cardiac toxicity associated with high-dose intravenous methotrexate therapy: case report and review of the literature.

A 36-year-old woman was hospitalized for preoperative chemotherapy for osteosarcoma. She received intravenous fluids for 12 hours for volume expansion, then methotrexate 24 g (12 g/m2) over 6 hours. This was followed by intravenous leucovorin 200 mg over 1 hour. Two hours after the methotrexate infusion the patient developed chest pain and bradycardia. An electrocardiogram revealed sinus pauses, and telemetry recordings indicated a 4-beat run of ventricular tachycardia. A cardiac work-up consisting of cardiac enzyme level determination, two-dimensional echocardiography, and an adenosine technetium-99m tetrofosmin stress test was negative for structural and ischemic heart disease. The patient recovered without treatment and, approximately 2 weeks later, received a second course of methotrexate at half the dose without complication. One month later the patient received treatment with doxorubicin and cisplatin; 2 days later she died unexpectedly at home. Clinicians should be aware that high-dose methotrexate can cause cardiac symptoms and arrhythmias in previously healthy adults. This complication warrants attention and needs additional clinical investigation.

Adult↗
PubMed1983

Patient-controlled analgesia.

Patient-controlled analgesia is a relatively new and investigational technique that permits patients to treat pain by directly activating doses of intravenous narcotics. The technique was developed in response to the undertreatment of pain in hospitalized patients. Continuous narcotic infusion and intraspinal narcotic administrations also have the potential to provide continuous, uninterrupted analgesia, but do not allow simple dose attentuation to avoid overdosage. Patient-controlled analgesia is used to treat postoperative and labor pain and pain associated with terminal illness; it delivers analgesic more effectively with fewer side effects than conventional parenteral narcotic therapies. The technique is also an ideal investigative instrument for studying equianalgesic states. Several foreign-made devices are now being used under investigational sanctions in this country, and it is anticipated that several American manufacturers will be seeking regulatory approval to market the devices.

Administration, Oral↗
PubMed2003

[Usefulness of a new nasal cannula with an end-tidal carbon dioxide measuring port].

BACKGROUND: During light sedation under local anesthesia, usually only percutaneous arterial oxygen saturation (SpO2) has been monitored for respiration. Measuring end-tidal carbon dioxide tension (EtCO2) has been difficult in such cases because of many air leaks from mask or cannula. We investigated the usefulness of a new nasal cannula with which EtCO2 can be monitored simultaneously with oxygen delivery. METHODS: Forty patients receiving epidural and spinal anesthesia were sedated with intravenous midazolam followed by propofol infusion. Oxygen 2l.min-1 was administered by a new nasal cannula of which one side of the face piece provides oxygen and the other side of it is an EtCO2 measuring port. SpO2 and EtCO2 were measured. RESULTS: The lowest SpO2 was 96 +/- 2%. The EtCO2 wave and value were demonstrated all the time during surgery in 24 patients, while in the other 16 patients sometimes it failed to indicate wave and value of EtCO2 when patients were snoring or moved their face. CONCLUSION: A new cannula with EtCO2 port is useful to oxygenate and measure EtCO2 simultaneously except when patients snore or move.

Adult↗
PubMed2005

Morphine for post-caesarean section analgesia: intrathecal, epidural or intravenous?

INTRODUCTION: Good analgesia is important after a caesarean section but there are no studies to date that compared intrathecal (IT), epidural (EP) and intravenous patient-controlled analgesia (IV PCA) morphine for post-caesarean section analgesia. In this study, we compared the differences in the quality of analgesia and side effects rendered by IT, EP and IV PCA morphine for post-caesarean section analgesia. METHODS: We systematically collected and reviewed the data of 949 women who received IT, EP or IV PCA morphine for post-caesarean analgesia during a six-month period. We reviewed the patients 24 hours after surgery and recorded the type of analgesia, the use of adjuncts, pain scores, side effects and degree of satisfaction with the mode of analgesia. The data was captured in an electronic database and analysed. RESULTS: IT morphine was the predominant method of post-caesarean analgesia, accounting for 89.5 percent of the cases. Non-steroidal anti-inflammatory drugs (NSAIDs) were more commonly used in the IT and EP group (IT 76 percent, EP 80 percent and IV PCA 49 percent, p-value is less than 0.05). IT morphine group had a significantly lower pain score at rest (p-value is less than 0.001) and on movement (p-value is less than 0.05) when compared with IV PCA group. EP morphine also resulted in a lower pain score than IV PCA on movement (p-value is less than 0.05). There was no difference in pain scores between EP and IT morphine. In the subgroup analysis of patients who did not receive NSAIDs, IT and EP morphine group also registered lower pain scores at rest and on movement than IV PCA group (p-value is less than 0.05). There was no difference in the satisfaction scores among the three groups. CONCLUSION: The use of IT and EP morphine was associated with lower pain scores than IV PCA morphine at rest and on movement in the first 24 hours after caesarean section. No severe side effects were found.

Adult↗
PubMedDate not supplied

[Methods of evaluation of disorders of the cerebrospinal fluid outflow resistance].

Diagnostic methods for estimating the disturbances of the intracranial fluid resorption process were presented. The following tests are described: constant rate infusion test, boluses, perfusion test, constant pressure infusion test. The methods were compared in the face of the concept of nonlinear outflow resistance--pressure relationship. The author presents his concept of the test for complex examination of outflow resistance--pressure relationship.

Cerebrospinal Fluid↗
PubMed1990

[Antifungal agents].

Explore the source record for details and available documents.

Administration, Oral↗
PubMed1989

Beneficial attenuating effect of L-threo-3,4-dihydroxyphenylserine on postural hypotension in anesthetized rats.

The effects of L-threo-DOPS (L-threo-3,4-dihydroxyphenylserine), a non-physiologic precursor amino acid of the natural form of norepinephrine, on postural hypotension were assessed in anesthetized rats. Rats were pretreated with DSP-4 (N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine), a norepinephrine-decreasing agent acting on central and peripheral tissues, or hexamethonium, a ganglion-blocking agent. Postural hypotension was induced by 60 degrees head-up tilt for 4 min. L-Threo-DOPS (1-10 mg/kg, i.v.) produced an increase in basal blood pressure and attenuation of the postural hypotension, which persisted in a dose-related manner in rats pretreated with DSP-4 (50 mg/kg, i.p. 24 h prior to the tilt-experiment). Hexamethonium (5 mg/kg, i.v.)-induced postural hypotension was also attenuated dose-dependently by i.p. (3-30 mg/kg)- or p.o. (30 and 100 mg/kg)-administered L-threo-DOPS, associated with an increase in basal blood pressure. Neither attenuation of postural hypotension nor increase in basal blood pressure was observed after L-threo-DOPS (30 mg/kg i.p.) in rats pre-injected with carbidopa (20 mg/kg i.v.), a peripheral aromatic L-amino acid decarboxylase inhibitor, under the hexamethonium pretreatment. The effects of L-threo-DOPS administered by cumulative i.v. infusion (12.5-50 micrograms/kg/min) on the pressor responses to either spinal sympathetic nerve stimulation (1-10 Hz) or i.v. bolus-injected tyramine were also examined. L-Threo-DOPS dose-relatedly potentiated the pressor response to nerve stimulation in rats either untreated or pretreated with DSP-4 and the pressor response to tyramine in rats pretreated with DSP-4.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia↗
PubMed1987

[Study on general anesthesia for cesarean section--condition of ventilation and inhaled O2 concentration].

UNLABELLED: The effects of ventilation on the fetus during general anesthesia for elective cesarean section were evaluated. METHOD: 62 healthy parturients (37-42 weeks) were divided into two groups, 40 received general anesthesia (G group) and 22 received spinal anesthesia (C group). All were given pre-operative infusion, journey tilt position and LUDD application. The G group was further divided according to the combination of O2 concentration and respiratory rate. General anesthesia was maintained by N2O-O2-halothane (0.5%). The C group was given 0.3% dibucaine with 100% O2 inhalation. ABM was used to monitor blood pressure, pulse rate, EMG, EEG, NMT and EtCO2. Maternal arterial blood (MA) and umbilical arterial and venous blood (UA, UV) were taken at delivery for measurement of PO2, PCO2, pH and B.E.. RESULTS: No significant change in blood pressure was found. There were positive correlations in EtCO2, MAPCO2 and UVPCO2. MAPCO2 decreased when the respiratory rate was increased. UVPCO2 and UVPO2 were not affected when MAPCO2 was below 23mmHg. When the O2 concentration was increased, MAPO2 also increased. Thus, pre-operative infusion, journey tilt position and LUDD application help to prevent hypotension. ABM, and especially, EtCO2, provides useful information. Slight hyperventilation and hyperoxygenation are better for the fetus.

Adolescent↗
PubMed1985

Ceftazidime in the therapy of pseudomonal meningitis.

In this study we report about the efficacy and tolerability of ceftazidime in the treatment of 10 cases of pseudomonal meningitis (nine Pseudomonas aeruginosa and one Pseudomonas cepacia). The 10 patients had a pseudomonal infection of the central nervous system (CNS) complicating neurosurgical procedures or developed on a preexisting immunodepressing condition; four patients were of pediatric age. All isolates were sensitive to ceftazidime with MICs ranging from 0.39 to 3.12 micrograms/ml. Ceftazidime was given intravenously at the dosage of 100-150 mg/kg/day. In seven cases amikacin was associated by intralumbar or intraventricular instillation. The duration of ceftazidime treatment ranged from 9 to 49 days with a mean of 22.2. Eight cases out of ten were cured bacteriologically and clinically, while the remaining two were cured after treatment with other antibiotics. Concentrations of ceftazidime in serum and in lumbar and/or ventricular cerebrospinal fluid (CSF) were obtained in four cases; the mean concentration in lumbar CSF was 12.2 micrograms/ml and in ventricular 3.3 micrograms/ml. The study demonstrated that ceftazidime is effective in the treatment of Pseudomonal meningitis.

Adolescent↗